Individual
GARY MARK PETERSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OTD, OTR/L
Contact information
Practice address
249 E OCEAN BLVD STE 440, LONG BEACH, CA 90802-4806
(888) 808-7838
(866) 620-3943
Mailing address
249 E OCEAN BLVD STE 440, LONG BEACH, CA 90802-4806
(888) 808-7838
(866) 620-3943
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
10906
CA
Other
Enumeration date
04/06/2011
Last updated
04/06/2011
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